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The Process of Genuine Peer-Review

          We begin this chapter with a reminder from one of the two brothers who invented the airplane, Orville Wright:   "If we all worked on the assumption that what is accepted as true really is true, there would be little hope of advance."

          Research, like most human activities, is necessarily a co-operative effort. Neither the Wright brothers nor any single individual begins "de novo." We all start with knowledge of the accumulated evidence, techniques, and insights of our predecessors and colleagues (peers). And whenever anyone launches a proposed new insight, the subsequent corrections, modifications, and additions from colleagues constitute the "peer review" which may really improve the initial work.

          We welcome genuine peer-review of our work. Indeed, we actively sought it for this book --- not from two or three anonymous "referees" of a single journal, but from countless peers in the fields of cancer causation and cancer prevention. It would be ill-informed to imagine that peer-review is limited just to comments in journals.

Part 1.   The Initial List for Stimulating Peer-Review

          Our initial list of book recipients (below) was designed to stimulate peer-review. With each book went a personal note inviting critiques or comments on the work. The list included some people who have a conflict of interest with respect to physician-causation and radiation-causation of cancer. Why did we not limit the list to colleagues who are free from a personal or a grant-related conflict? Because bias does not always interfere with valid scientific criticism. Everyone on the list below received the book from us in April, May, or June of 1995:

o - American Cancer Society:

          Twenty-two individual physicians, of the American Cancer Society's Medical Affairs Committee and Editorial Advisory Board, received books.

Ahmann, David L., Prof. Oncology, Mayo Clinic, Rochester, MN.
Averette, Hervy, Prof. Gyn. Onc., Sylvester Cancer Ctr., Miami.
Bal, Dileep G., Chief, Chronic Diseases, Calif. State Health Dept.
Beerline, Donald, Pathology, Mt. Diablo Medical Ctr., Concord CA.
Cunningham, Myles P., Univ. of Illinois College of Medicine.
DeMare, Paul A., Queen's Medical Ctr. Radiation Oncology, Honolulu.
Dodd, Gerald D., Chair, Diagnostic Imaging, M.D. Anderson Ca.Ctr.
Donegan, Wm. L., Chair, Surgery, Sinai Sam. Med. Ctr., Milwaukee.
Foley, John F., Prof. of Med., Univ. Nebraska Med. Ctr., Omaha.
Haase, Gerald M., Prof. Pediatric Surg., Children's Hosp., Denver.
Hanke, C. Wm., Dir., Mohs Micrographic Surgery Unit, Indianapolis.
Harper, A. Patricia, Med. Dir., Indianapolis Breast Center.
Joseph, Rosaline R., Dept. Med., Med. College of PA, Philadelphia.
Klatt, Gordon R., M.D., Tacoma, Washington.
Lang, Nicholas P., Dept. Surgery, Univ. Arkansas, Little Rock.
Lange, Richard H., Mohawk Val. Physicians Health Plan, Schenectady.
Leitch, A. Marilyn, Prof. Surg., Univ. Texas SW Med. Ctr., Dallas.
Levitt, Seymour H., Chair, Ther. Radiol., Univ. Minnesota, Minneap.
Mansour, Ed. G., Dir. Surg. Onc., MetroHealth Med. Ctr., Cleveland.
Murphy, Gerald P., Dir., Pacific NW Research Inst., Seattle.
Simmons, Jerry L., Prof. Clin. Med., So. Dakota Sch. of Medicine.
Woolam, Gerald L., Surg., St. Mary of Plains Hosp., Lubbock, TX.

Of the above group, not one acknowledged receipt of the book.

o - American Medical Association (see Chapter 44):

Three individual editors of the Journal received books:
Lundberg, George D., M.D., Editor of JAMA
Flanagin, Annette, R.N., M.A., Associate Senior Editor
Meyer, Harriet S., M.D., Book Editor

o - British radiation establishment (see Chapter 46):

National Radiological Protection Board, in Didcot.
Dr. Colin R. Muirhead, Chief of Epidemiology.
Health and Safety Executive, in Sheffield.

o - California Breast Cancer Research Council (see Part 3, below)

Claymon, Susan, Breast Cancer Action, San Francisco.
Hopper, Cornelius, M.D., Univ. Calif. V.P. Health Affairs, Oakland.
Shinagawa, Susan M., M.D., Univ. Calif. Cancer Ctr., San Diego.

Not one acknowledged receipt of the book.

o - Canadian National Cancer Institute, Breast Cancer Initiative

Dr. Elizabeth Kaegi, NCI Breast Cancer Initiative, Toronto.
Louise Liao, NCI Breast Cancer Initiative, Toronto.

Neither one acknowledged receipt of the book.

o - National Action Plan on Breast Cancer (USA)

          This is a government-private "partnership" formed in December 1993, with initial co-chairs from the U.S. Dept. of Health and the National Breast Cancer Coalition:   19 members of the leadership roster received books from us in May 1995.

Apantaku, Funmi, Dept. Epidem. & Biostat., Univ. Illinois, Chicago.
Blumenthal, Susan J., M.D., Dep. Asst. Secy. for Health, USDHHS.
Brinton, Dr. Louise A., Env. Epidem., National Cancer Inst.
Brogan, Dr. Donna, Etiology, Env. Epidem., National Cancer Inst.
Browne, Doris, M.D., Ph.D., Office Asst. Secy. Defense, Health Aff.
Burhansstipanov, Dr. Linda, Native Am. Ca. Research Ctr., Denver.
Crisp, Dr. Tom, Office Research & Biol., U.S. Envir. Prot. Agency.
Evans, Nancy, ex-president of Breast Cancer Action, San Francisco.
Fenner-Crisp, Dr. Penelope, Pesticide Programs, US EPA.
Haynes, Dr. Suzanne, Senior Advisor, Women's Health, US Dept. HHS.
Liburdy, Dr. Robt. P., Lawrence Berk. Lab Life Sciences, Univ. CA.
Malins, Dr. Donald C., Pacific NW Research Foundation, Seattle.
McLachlan, Dr. John A., Ctr. Envir. Research, Tulane Univ. Med.Ctr.
Robert-Guroff, Dr. Marjorie, Cancer Etiology, Natl. Cancer Inst.
Saslow, Dr. Deborah, Off. on Women's Health, US Dept. Health & HS.
Sieber, Dr. Susan M., Dep. Dir. for Ca. Etiology, Natl. Canc. Inst.
Soto, Ana M., M.D., Tufts Med. Sch. Reproductive Research, Boston.
Visco, Frances M., President of the Natl. Breast Cancer Coalition.
Zahm, Dr. Sheila Hoar, Ca. Etiology, National Cancer Institute.

Of this group, Nancy Evans acknowledged receipt.

o - Radiation Effects Research Foundation, in Hiroshima

Mendelsohn, Mortimer, M.D., Ph.D., Associate Director.
Preston, Dr. Dale L.

o - Additional Early Recipients

Bailar, John C. III, M.D., PhD.; Chair Epid., McGill Univ., Montreal.
Benson, Allen B., PhD.; Prof.Chem.; author Radioactive Fallout 1989.
Bertell, Dr. Rosalie; rad'n analyst; Internatl. Institute, Toronto.
Bradley, David J., M.D.; author books, incl. No Place to Hide 1984.
Clapp, Dr. Richard W.; Envir. Health, Boston U. Sch. Public Health.
Cobb, John Candler, M.D., MPH; Prof. Emer. Epid., Univ. Colorado.
Davis, Devra Lee, Ph.D.; Office of Asst. Secy. for Health, USDHHS.
Elkind, Mortimer L., M.D.; Radiol. Health Sci., Colorado State U.
Epstein, Samuel, M.D.; Univ. Illinois Sch. Public Health, Chicago.
Fredrickson, Donald S., M.D.; former head, Natl. Inst. of Health.
Good, Robert A., M.D.; All Children's Hospital, St. Petersburg FL.
Gould, Dr. Jay M.; Radiation & Public Health Project, NYC.
Grundy, Scott, M.D., Ph.D.; Univ. TX. SW Med. Ctr., Dallas.
Henderson, I. Craig, M.D.; Chair, Med. Onc., UCSF Cancer Ctr.
Hoffman, Dr. Daniel A.; Geo. Washington Univ. Medical Sch, Wash DC.
Kirsch, Jan, M.D.; onc; Mt. Diablo Reg. Cancer Ctr., Concord CA.
Kohnlein, Dr. Wolfgang; Inst. Strahlenbiol., W-W Univ., Munster.
Kradjian, Robert M., M.D.; onc., author, Save Yourself from Br.Ca.
Land, Charles E., Ph.D.; radiation epid., Natl. Cancer Inst.
Landrigan, Phillip, M.D.; Community Med., Mt. Sinai Med. Ctr., NYC.
Love, Susan M., M.D.; author; Dir. Revlon/UCLA Breast Center.
Montague, Dr. Peter; dir., Envir. Research Foundation, Annapolis.
Moore, Francis, M.D.; New England Journal of Medicine, Boston.
Morgan, Karl Z., Ph.D.; "father" of health physics; ICRP emeritus.
Morton, Wm. E., M.D., Ph.D.; Sch. of Medicine, Oregon Health Sci.
Moses, Marion, M.D.; author; founder, Pesticide Education Ctr.
Moss, Ralph W., Ph.D.; author; NIH Advisory Counc. Alternative Med.
Nussbaum, Rudi H., Ph.D.; radiation analyst; Portland State U., OR.
O'Toole, Dr. Tara; Deputy Secretary of Energy, US Dept. of Energy.
Peters, John M., M.D.; Preventive Med., Univ.So.Calif. Sch. of Med.
Pilgrim, Ira H., Ph.D.; retired cancer biologist, Laytonville, CA.
Radford, Edward P., M.D.; Chair of the BEIR-3 Com'tee; Surrey, UK.
Ragovin, Cathie, M.D.; Exec. Bd. Member, Mass. Br. Ca. Coalition.
Read, Cathy; Brit. physician; author, Prev. Br. Ca.: Politics.
Richter, Dr. Elihu; Occ. Med., Hebrew Univ. Med. Sch, Jerusalem.
Rush, David, M.D.; epidem. Tufts Univ.; author 1992 Dead Reckoning.
Slesin, Louis, Ph.D.; founder and editor, Microwave News, NYC.
Sloan-Kettering Cancer Ctr.; Mortimer Chute, Senior Vice President.
Steingraber, Sandra, Ph.D.; biologist; author; cancer activist.
Sternglass, Ernest, Ph.D.; physicist; author of radiation studies.
Stewart, Alice, M.D.; pioneer, Oxford Survey Childhood Canc., UK.
Strauss, Harlee, Ph.D.; Dir., Silent Spring Institute, Newton, MA.
Warf, James C., Ph.D.; USC chem.; author 1990 All Things Nuclear.
Whelan, Dr. Wm.J.; Editor Journal Fed. Amer. Soc. Experimental Biol.
Wilkinson, Dr. Gregg; Epid.& Prev. Med., U.TX. Med. Ctr.,Galveston.
Wing, Steve, Ph.D; Epid., Univ. of No. Caro. Sch. of Public Health.
Zippin, Calvin, Sc.D.; Prof.Emeritus Epid.& Biostat., UCSF Med.Sch.
Part 2.   Why Consume This Valuable Space?

          The reason we consume valuable space on the issue of peer-review is because people who want to imply the work is worthless (whether or not they have ever read it) often say nothing more than, "Well, you know the book is not peer-reviewed!"

          These ostensible fans of independent peer-review are often the people who treat as "gospel wisdom" any book, report, or monograph self-published and self-reviewed by the national and international "radiation committees" (BEIR, ICRP, NCRP, NRPB, RERF, UNSCEAR;   respectively, Biological Effects of Ionizing Radiations, USA-NAS;   International Commission on Radiological Protection;   National Council on Radiation Protection, USA;   National Radiological Protection Board, Britain;   Radiation Effects Research Foundation, USA-Japan;   United Nations Scientific Committee on the Effects of Atomic Radiation).

          The radiation committees do not submit their self-published books and reports for pre-publication review by independent peer-reviewers like myself. Independent review begins after publication.

          So, many of the people who say "Gofman's book is not peer-reviewed!" are just using a double-standard. Unless they can offer a critique of some substance, they contribute obstacles rather than insights to the scientific effort.

          Now this book is in a genuine peer-review process, as the following chapters will amply demonstrate. The book may already be one of the most peer-reviewed books in the field.

          Readers of the next chapters may wonder, "Weren't there any favorable comments?" Yes, there were many (even a few from the fiercest critics), but the positive comments are not in our text because they require no response from us.

Part 3.   Comments Which Speak for Themselves

          Not every comment by a colleague qualifies as peer-review. Comments about a 300-page study fail to qualify whenever their makers have not even seen the work, much less studied it! A rush to judgment speaks for itself.

          No advance-copies of the First Edition were issued to anyone, although we talked freely about the work with interested peers, activists, and reporters. The printer produced the first copies on March 28, 1995. Examples of comments issued before that date include:

          o - Charles L. Gruder, Ph.D., Director of the Breast Cancer Research Program, a program of research and education grants funded by a special California tax on cigarettes, and administered for the California Legislature by the University of California, wrote:

          "I regret to inform you that the Breast Cancer Research Program has decided not to invite you to submit a grant application based on the project proposed in the above-referenced Letter of Intent (LOI). [Our Letter of Intent to Submit a Grant Application described, in three double-spaced sheets, the findings set forth in this book, and it promised that a copy of the book would accompany the Grant Application.] All LOIs were reviewed by screening committees comprised of peer reviewers and members of the BCRP's Breast Cancer Research Council;   screening committee rosters will be released when grants are announced." I had intended to request a one-year grant of $35,000.

          The refusal, even to receive a grant application based on the thesis of this book, was dated February 1, 1995 --- eight weeks before the book was available for peer-review examination.

          You do the peer-review first, and then you don't even have to look at the work itself? We call this peer-preview, not peer-review.

          The mandate of California's Breast Cancer Research Program is to support "innovative research to enhance understanding of the causes of breast cancer;   access to early detection services... ;   and the development of more effective interventions for preventing the incidence and progression of breast cancer." The only comment from the peer-review committee on its LOI evaluation-form was that my work would be "not responsive" to these goals. With an "x" in the correct box, the committee did acknowledge that I am an "established investigator."

          o - Gerald Dodd, M.D., a former president of the American Cancer Society and emeritus professor of radiology at the University of Texas M.D. Anderson Cancer Center: "I see absolutely no way that he [Gofman] can make his determinations with any degree of accuracy ... What can be said is that even if you assume the worst, the number of cancers that are produced by radiation are far outnumbered by the number that occur spontaneously, and at least half of those can be arrested by timely treatment." From an interview by Dr. Peter Radetsky, quoted in the February 1995 issue of Longevity Magazine (p.88, 90).

          Criticism:   January 1995.
          First availability of the work criticized:   April 1995.

          o - Stephen A. Feig, M.D., professor of radiology at the Thomas Jefferson University Hospital in Philadelphia:   "Respected people disagree with Gofman. They don't take him seriously ... He doesn't make any sense. If there is a risk from very low doses [of radiation], it's so small you can't even measure it." From an interview by Dr. Peter Radetsky, quoted in the February 1995 issue of Longevity Magazine (p.90).

          Criticism:   January 1995.
          First availability of the work criticized:   April 1995.

Part 4.   Not Taken Seriously?

          Flimsy personal attacks, such as the one by Dr. Feig above, should be put into perspective by just a few statements from other sources.

          o - Devra Lee Davis, Ph.D., MPH, senior advisor to the Asst. Secretary for Health, U.S. Department of Health and Human Services:   "I think Gofman is making a very important contribution. There's growing evidence to show that past uses of radiation may explain some part of the increase in breast cancer." Quoted in Your Health, Vol.34, No.12, June 13, 1995.

          o - Mortimer Mendelsohn, M.D., Ph.D., Associate Director of the Radiation Effects Research Foundation in Hiroshima, and former Associate Director of the Livermore National Laboratory:   "John Gofman is a superb analyst and has always been at the cutting edge of medical science, particularly when it comes to protecting people." A 1995 on-camera statement in the half-hour program "The X-Ray Effect" (based on this book), produced by London's 20/20 Television and broadcast over Britain's Carlton TV network on August 3, 1995.

          o - Edward P. Radford, M.D., epidemiologist and Chairman of the BEIR-3 Committee (Biological Effects of Ionizing Radiations) of the National Academy of Sciences, USA:   "Dr. Gofman is owed a debt of gratitude by the scientific community because he was one of the first people to raise the issue of cancer risks from radiation exposure." A 1995 on-camera statement in the half-hour program "The X-Ray Effect" (based on this book), produced by London's 20/20 Television and broadcast over Britain's Carlton TV network on August 3, 1995.

    "A dwarf standing on the shoulders of a giant may see
    farther than the giant himself."

* - Didacus Stella, A.D. 39-65.          

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